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在活动性类风湿关节炎晚期患者中使用非甾体类抗炎药。

USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH ADVANCED ACTIVE RHEUMATOID ARTHRITIS.

机构信息

Dubrava University Hospital, Department of Physical and Rehabilitation Medicine with Rheumatology, Zagreb, Croatia.

Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia.

出版信息

Acta Clin Croat. 2022 Dec;61(4):588-598. doi: 10.20471/acc.2022.61.04.04.

Abstract

This study aimed to determine whether patients with active rheumatoid arthritis (RA) regularly take non-steroidal anti-inflammatory drugs (NSAIDs) and to clarify whether their decision to take NSAIDs depends on disease activity, intensity of pain, or functional status. The study also aimed to identify the risk factors for gastrointestinal side effects. Over 6 months, we conducted a cross-sectional single-center study of consecutively hospitalized patients with confirmed RA. Activities of daily living, pain intensity, and disease activity were evaluated by the Health Assessment Questionnaire, visual analog scale, and disease activity score, respectively, in 28 joints. Of 73 patients diagnosed with RA, 48 (66%) regularly took NSAIDs. Compared to non-users, NSAID users used glucocorticoids less frequently. The decision to use NSAIDs was independent of disease activity, pain intensity, degree of functional impairment, or presence of gastrointestinal risk factors. However, a higher degree of functional impairment was associated with a longer duration of continuous NSAID and glucocorticoid use. NSAIDs are still relevant for RA treatment. The decision to use them is not necessarily affected by disease activity or pain intensity, but their prolonged use is required in patients with a higher degree of functional disability. NSAIDs enable exclusion of glucocorticoid use, sparing patients of glucocorticoid-related side effects.

摘要

本研究旨在确定活动性类风湿关节炎(RA)患者是否定期服用非甾体抗炎药(NSAIDs),并阐明他们服用 NSAIDs 的决定是否取决于疾病活动度、疼痛强度或功能状态。本研究还旨在确定胃肠道副作用的风险因素。在 6 个月的时间里,我们对连续住院的确诊 RA 患者进行了一项横断面单中心研究。通过健康评估问卷、视觉模拟量表和 28 个关节的疾病活动评分,分别评估日常生活活动、疼痛强度和疾病活动度。在 73 名确诊为 RA 的患者中,有 48 名(66%)定期服用 NSAIDs。与非使用者相比,NSAID 使用者较少使用糖皮质激素。使用 NSAIDs 的决定与疾病活动度、疼痛强度、功能障碍程度或胃肠道风险因素无关。然而,较高的功能障碍程度与持续 NSAID 和糖皮质激素使用时间的延长有关。NSAIDs 仍然是 RA 治疗的重要药物。使用 NSAIDs 的决定不一定受疾病活动度或疼痛强度的影响,但在功能障碍程度较高的患者中需要长期使用 NSAIDs。NSAIDs 可以排除糖皮质激素的使用,使患者免受糖皮质激素相关副作用的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53b8/10588376/93c460f86e8b/acc-61-588-f1.jpg

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